Massive blood transfusion in choroid plexus tumor surgery: 10-years' experience

Piastra, Marco; Rocco, Concezio Di; Tempera, Alessia; Caresta, Elena; Zorzi, Giulia; Tosi, Federica; Massimi, Luca; Pietrini, Domenico

doi:10.1016/j.jclinane.2006.10.010

Cited by 19 publications

(10 citation statements)

References 36 publications

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“…As a result, we recommend limiting the resection to avoid neurologic injury. Overall, the incidence of complications observed in our study compares favorably with other published studies [5,7,9,11], particularly those including patients treated in the pre-microsurgical era [6,12,13], in which perioperative mortality was high, especially in children [14][15][16][17][18][19]. Compared to published series from the modern microsurgical era, our observed morbidity and mortality were very minimal, once again confirming that these tumors can be safely resected in both children and adults [2,3,5,9,11].…”

Section: Discussionsupporting

confidence: 84%

Surgical outcomes in choroid plexus papillomas: an institutional experience

et al. 2013

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Choroid plexus papillomas (CPPs) are rare, indolent lesions that comprise less than 0.5 % of intracranial tumors. We sought to assess the long-term outcomes and associated surgical complications at our institution. A review of the University of California, San Francisco (UCSF) Brain Tumor Research Center (BTRC) database was performed to identify a cohort of patients treated for CPP from 1997 to 2011. Patients were grouped based on tumor location and extent of resection. Outcomes including progression-free survival and surgical complications were assessed. We identified 24 patients (16 female, 8 male) ranging in age from 6 months to 55 years (median 29 years) treated at our institution. Tumors were found in the following locations: 16 (67 %) fourth ventricle/cerebellopontine angle; 7 (29 %) lateral ventricle; 1 (4 %) third ventricle. Gross total resection (GTR) was achieved in 20 patients (83 %) with subtotal resection (STR) in 4 (17 %). Median follow-up time was 2.8 years with 3 recurrences identified at 1.6, 3.3, and 8.5 years. Extent of resection and tumor location were not associated with recurrence. There was one new permanent neurologic deficit detected after surgery. All patients were alive at most recent follow-up. Attempted gross total resection is the standard treatment for CPPs and generally associated with excellent outcomes. Since recurrences are rare, even among patients who undergo STR, radiation may be reserved for cases of tumor progression. This modern experience at a tertiary care center performed exclusively during the MRI-era demonstrates that CPPs can be safely removed with minimal morbidity and good tumor control.

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Section: Discussionsupporting

confidence: 84%

Surgical outcomes in choroid plexus papillomas: an institutional experience

et al. 2013

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“…Unfortunately, we were unable to procure the previous slides for review. [4] however, frank DIC is unusual. [4,5] The clinical picture along with the laboratory findings (low levels of fibrinogen, elevated levels of fibrin degradation products, and less number of platelets) in our patient confirmed a diagnosis of DIC with secondary hyperfibrinolysis.…”

Section: Hyperacute Disseminated Intravascular Coagulation Following mentioning

confidence: 95%

“…[4] however, frank DIC is unusual. [4,5] The clinical picture along with the laboratory findings (low levels of fibrinogen, elevated levels of fibrin degradation products, and less number of platelets) in our patient confirmed a diagnosis of DIC with secondary hyperfibrinolysis. [6] Its rapid occurrence early during surgery was the interesting aspect and took us by surprise.…”

Section: Hyperacute Disseminated Intravascular Coagulation Following mentioning

confidence: 95%

Hyperacute disseminated intravascular coagulation following surgery for a choroid plexus carcinoma in a child

2010

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“…Choroid plexus tumors occur at a higher incidence in the first few years of life, 27 and blood loss represents a significant surgical risk for these young patients. 24 Total surgical excision is the most effective treatment for choroid plexus carcinomas. 6,23 Preoperative intravascular embolization should be considered and has been shown to help with the surgical management of these lesions.…”

Section: Tumor Categoriesmentioning

confidence: 99%

United Kingdom 30-day mortality rates after surgery for pediatric central nervous system tumors

O’Kane

Mathew

Kenny

et al. 2013

PED

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Object In an increasing culture of medical accountability, 30-day operative mortality rates remain one of the most objective measurements reported for the surgical field. The authors report population-based 30-day postoperative mortality rates among children who had undergone CNS tumor surgery in the United Kingdom. Methods To determine overall 30-day operative mortality rates, the authors analyzed the National Registry of Childhood Tumors for CNS tumors for the period 2004–2007. The operative mortality rate for each tumor category was derived. In addition, comparison was made with the 30-day operative mortality rates after CNS tumor surgery reported in the contemporary literature. Finally, by use of a funnel plot, institutional performance for 30-day operative mortality was compared for all units across the United Kingdom. Results The overall 30-day operative mortality rate for children undergoing CNS tumor surgery in the United Kingdom during the study period was 2.7%. When only malignant CNS tumors were analyzed, the rate increased to 3.5%. One third of the deaths occurred after discharge from the hospital in which the surgery had been performed. The highest 30-day operative mortality rate (19%) was for patients with choroid plexus carcinomas. A total of 20 institutions performed CNS tumor surgery during the study period. Rates for all institutions fell within 2 SDs. No trend associating operative mortality rates and institutional volume was found. In comparison, review of the contemporary literature suggests that the postoperative mortality rate should be approximately 1%. Conclusions The authors believe this to be the first report of national 30-day surgical mortality rates specifically for children with CNS tumors. The study raises questions about the 30-day mortality rate among children undergoing surgery for CNS tumors. International consensus should be reached on a minimum data set for outcomes and should include 30-day operative mortality rates.

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Massive blood transfusion in choroid plexus tumor surgery: 10-years' experience

Cited by 19 publications

References 36 publications

Surgical outcomes in choroid plexus papillomas: an institutional experience

Surgical outcomes in choroid plexus papillomas: an institutional experience

Hyperacute disseminated intravascular coagulation following surgery for a choroid plexus carcinoma in a child

United Kingdom 30-day mortality rates after surgery for pediatric central nervous system tumors

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